Advocate: Doctor supervision of nurses 'unsustainable'

An advocate for nurse practitioners argued Tuesday that forcing NPs to work under the supervision of a doctor would be “unsustainable” as demand for primary care ramps up under the federal health law.

Angela Golden, president of the American Association of Nurse Practitioners, said at a POLITICO Pro Breakfast Briefing that requiring doctors to oversee nurse practitioners' care would limit their reach as the workforce grows over the next decade.

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“When you regulate that, you put an additional barrier between the patient and the care ... provided for them,” Golden said.

Dan Hawkins, senior vice president of policy and research for the National Association of Community Health Centers, added that in medically underserved communities such as rural Alaska, doctors often need to move between multiple sites, necessitating nurse practitioners or physicians’ assistants to operate “independently.”

“It should not require on-site, physical supervision of that individual,” he said.

“The reason that nurse practitioners are very wary of any regulatory framework for this is because there’s a professional framework for this,” she said.

Terie Norelli, speaker of the New Hampshire House of Representatives and president of the National Conference of State Legislatures, added that state lawmakers making decisions about these regulations need data — and the federal government should assist them in that effort.

But Hawkins countered that states need more than data — they need to change their mindsets. “There’s a dichotomy in which the states that most need to grant broader authority to non-physician providers are the same ones … that refuse to do so. That needs to change,” he said.

This article first appeared on POLITICO Pro at 9:01 a.m. on March 19, 2013.